Prevalence of H. pylori among asymptomatic HIV-positive and negative individuals in Central Ethiopia and efficacy of eradication therapy.

Objectives: Helicobacter pylori is a widespread pathogen and major contributor to dyspeptic disease and gastric cancer. Although the interaction between HIV and H. pylori infection is not well investigated, previous studies have suggested a decreased prevalence of H. pylori and limited efficacy of eradication therapy in HIV-positive individuals. Therefore, the objectives of this study were to describe the prevalence of H. pylori infection according to HIV status and analyze the efficacy of eradication therapy in Ethiopia. Methods: A prospective, randomized, interventional study was performed involving HIV-positive and negative participants presenting to the Asella Referral and Teaching Hospital in Central Ethiopia between March and June 2017. A stool antigen test was used as a screening tool for H. pylori infection. Randomly selected patients received triple eradication therapy. Results: The cumulative H. pylori prevalence was 77.3% (392/507): 78.8% (241/306) among HIV-positive individuals versus 75.1% (151/201) among HIV-negative individuals (P = 0.386). Twenty-five HIV-positive and 26 HIV-negative H. pylori-infected participants were randomized to receive standard triple therapy; three of them were lost to follow-up (one HIV-positive, two HIV-negative). The total eradication rate was 50.0%: 62.5% (15/24) among those HIV-negative versus 37.5% (9/24) among those HIV-positive [Au?1]. Conclusions: A high prevalence of H. pylori was observed among HIV-positive and negative individuals in Central Ethiopia. The efficacy of eradication therapy was low, with a trend towards lower efficacy in HIV-infected individuals.

The implementation of the Kinyoun staining technique in a resource-limited setting is feasible and reveals a high prevalence of intestinal cryptosporidiosis in patients with HIV.

OBJECTIVES: In resource-limited settings, intestinal Cryptosporidial or coccidian infections are common causes of chronic diarrhea but usually remain undiagnosed by routine stool investigation. Here, the addition of the Kinyoun staining technique after stool concentration was evaluated as an easy and inexpensive method for diagnosis of intestinal parasitic infection in patients with HIV. METHODS: This cross-sectional study investigated patients with HIV with diarrhea and randomly selected patients with HIV without diarrhea as controls. Stool samples were examined by wet mount microscopy and Kinyoun staining after stool concentration. Clinical, sociodemographic, and behavioral data were collected. Statistical analysis was performed using chi-squared test and multivariate regression analysis. RESULTS: In total, 163 participants were included (62.0% female, mean age 38.2 [SD ± 10.7] years). Diarrhea was present in 52.1% (85/163). The prevalence of intestinal parasites was 18.4% (30/163). Cryptosporidial infections were more frequent among patients with diarrhea (12.9% [11/85] vs 1.3% [1/78], P = 0.005) and in patients with CD4+ cell count <200 cells/µl (25.9% [7/27] vs 3.7% [5/136], P = 0.001). Risk factors for intestinal parasitic infections were diarrhea and the habit of regularly eating uncooked food. Kinyoun staining was necessary for the detection of cryptosporidiosis. CONCLUSION: In our cohort, the prevalence of intestinal parasitic infection was high, especially after additional use of Kinyoun staining for detection of Cryptosporidia or intestinal coccidia. Considering its clinical relevance, particularly in individuals at risk, the implementation of this technique should be considered in resource-limited settings.

Assessment of status of solid waste management in Asella town, Ethiopia.

BACKGROUND: Improper solid waste management (SWM) is a major public health and environmental concern in the urban areas of many developing countries such as Asella Town. The aim of this study was to assess the status of SWM in Asella town. METHODS: A community-based cross-sectional study design was used to assess the status of improper SWM and associated factors in Asella town. From the total of eight kebeles (smallest administrative unit in Ethiopia) four kebeles were randomly selected using lottery method. The sample size was 413 households. The households were proportionally allocated to each randomly selected kebeles. The data was collected by pretested questionnaire in the local language. Data was entered using statistical software Epi Info version seven and transferred to SPSS version 21. Descriptive data analysis was done to summarize the socioeconomic status of the respondents. Chi-square was used to show the association between the status of solid waste management and different variables. Binary logistic regression was used to determine the potential factors for improper SWM. RESULT: 332 (82.8%), had improper solid waste management practice. Lack of adequate knowledge about solid waste management and not having access to door to door solid waste collection could have contributed to the reported improper solid waste practice. Participants who didn't have access to door to door solid waste collection service were about three times more likely to practice improper solid waste management when compared to those who had access (AOR = 2.873, 95 CI (1.565,5.273) P = 0.001). CONCLUSION: The study finding showed that, the majority of the residents practiced improper solid waste management. Lack of adequate knowledge about solid waste management and not having access to door to door solid waste collection could have contributed to the reported improper solid waste practice. Therefore, there is a need to enhance the awareness of the community about proper SWM and to improve the door to door solid waste collection service by the town municipality.